Reply: Obstetric injury claims are not happening at random; The size of the labor unit matters

摘要

We thank AOGS for the possibility to address some of the issues raised by Nielsen and Clausen. We are convinced that patient claims do not only appear at random, and we judge that our study has shown this. Families involved in preventable major obstetric injuries most likely draw the same conclusion.The perfect parameter to measure obstetric patient safety does not exist. The aim of the study "The size of the labor wards: is bigger better when it comes to patient safety?" (1) was to assess any possible relation between the size of the labor units in Denmark and the frequency of approved claims. Our key finding showed that large labor units (3000-3999 deliveries/year) had a lower approval rate per number of submitted claims compared with small (<1000 deliveries/year), intermediate (1000-2999 deliveries/year), and very large units (>4000 deliveries/year). No significant difference was identified with regard to the number of submitted claims per number of deliveries between the different sizes of labor units, and on top of this, large labor units are serving a high-risk population to a greater degree, and one could expect a greater potential for injuries happening there.